[Sublingual artery injury during dental implantation using a surgical navigation guide]. / Povrezhdenie pod"yazychnoi arterii pri dental'noi implantatsii s primeneniem khirurgicheskogo navigatsionnogo shablona.

The article presents a clinical case of hemorrhage due to sublingual artery injury during the installation of four dental implants in the lower jaw using a surgical navigation guide. In a detailed analysis of the case and the surgery, the main cause of this complication was determined. It must be taken into account while planning a surgery on edentulous jaws or with the single-stage full dental extraction on the lower jaw. Ensuring strict guide immobility is essential for correct drilling, wherefore it is necessary to make a fixing key in the occluder or articulator.

[The Development of Pulmonary Damage When Receiving Amiodarone].

In this report we describe in detail a case from clinical practice of the most dangerous side effect of an antiarrhythmic agent amiodarone - amiodarone induced pulmonary toxicity.

Mucosal barrier in ulcerative colitis and Crohn's disease.

Background. The mucus layer in the gastrointestinal tract plays important role in host innate defense, regulation of secretion, and absorption processes, maintaining colonization resistance, which composes the integrity of protective mucus barrier in the large intestine. Investigations of mucin expression in the colon mucosa can improve the understanding of protective function of mucosal barrier in ulcerative colitis (UC) and Crohn's disease (CD). Materials and Methods. 77 patients with UC and CD were examined. Histological analysis of colon mucosa was done by standard method (haematoxylin-eosin, alcian blue at pH 1.0 and 2.5 to determine sulfated and nonsulfated glycosaminoglycans and glycoproteins, and goblet cells). To characterize the mucus production the PAS-reaction was performed. Immunohistochemistry was performed using monoclonal mouse antibodies raised against MUC2, MUC3, MUC4, and TFF3 (USBiological, USA). Results. The moderate expression of MUC2 and MUC3 (50.0% and 32.1%, P = 0.03) and high expression of MUC4 and TFF3 in the colon mucosa were observed in all patients with CD. The intensive labeling of MUC4 and TFF3 occurred more often (42.9% and 57.1%, P = 0.03) in patients with CD. The level of expression of secretory MUC2 and transmembrane MUC3 and MUC4 in all patients with UC was low, up to its complete absence (59.2% and 53.1% cases, P = 0.05). TFF3 expression had high and medium staining intensity in patients with UC. Conclusions. Different types of mucins synthesis, secretion, and expression were found in patients with UC and CD. The expression of mucin MUC2, MUC3, MUC4, and TFF3 correlated with the activity of disease and the extent of the inflammatory process in the large intestine. The most pronounced alteration of mucins expression was observed in patients with severe UC and CD.

Markers of epithelial-mesenchymal transition in renal cell carcinoma.

AIM: To study the influence of markers of epithelial-mesenchymal transition (EMT) on a renal cell carcinoma (RCC) prognosis. METHODS: The surgical material of 47 RCC patients who underwent nephrectomy was studied. RCC patients were distributed in two groups: a short-term survival group (3-6 months) and a long-term survival group (17-24 months). EMT markers expression was assessed by immunohistochemical methods. RESULTS: It was determined that the rate of spindle-cell EMT was 96.4% in a short-term survival group and 42.1% in a long-term survival group. High rate Furhman's nuclear atypia, i.e. degree 3-4 occurred in 100% of cases in a short-term survival group versus 68.4% in a long-term survival group. CONCLUSION: The rate of spindle-cell EMT in RCC may serve a more sensible prognostic factor than the degree of Furhman's nuclear atypia.

[Regional "occupational medicine" system--effective model of occupational risks evaluation and management].

Sverdlovsk regional government specified and approved a concept of diversified system "Occupational medicine" to preserve and improve health of workers in Sverdlovsk region. Implementation of the concept enables to put new organizational approaches into practice for improved management of available medical care for all workers, for increased quality of this care, for better clinical work and better health of economically active population in Sverdlovsk region.

Joint extraintestinal manifestations in ulcerative colitis.

An extraintestinal manifestation (EIM) very often occurs in ulcerative colitis (UC) patients. EIM modifies the natural course of UC and decreases the quality of life in these patients. The aim of this study was to analyze clinical and laboratory findings in UC patients with joint EIM. 319 UC patients were examined. Among them were 131 (41.1%) patients with distal UC, 102 (32.0%) suffered from left-sided UC and 86 (26.9%) had pancolitis. 95 (29.8%) UC patients had joint EIM. Arthritis correlated with extensive forms of UC and was more often determined in patients with left-sided UC and pancolitis. Arthralgia was a prevalent symptom of joint EIM in patients with distal UC. Colon microbiocenosis and the mucosal barrier in UC patients were analyzed. The cytokine status with privileged cytokine profile changes was investigated. In all UC patients, dysbiosis with a decreasing quantity of bifidobacteria, lactobacilli and Escherichia coli was found, but an increase of facultative flora was also found. At the same time, an association of facultative flora in UC patients with arthritis was observed. In these patients, Staphylococcus, Klebsiella and Proteus were found more often in stool cultures. These associations correlated with a modification of the colonocytes' cell receptor maturity of mucus, a condition with a decreased staining intensity by lectins. A cytokine imbalance with an increase of proinflammatory and a decrease of anti-inflammatory cytokines was found in all UC patients. The privileged cytokine profile changes in UC patients with joint EIM were analyzed. Maximal increases of IL-1 and TNF with decreases of IL-10 in plasma in patients with joint EIM were observed.

[Modifications of gastric mucosa in diffuse and intestinal cancer]. / Izmenenie slizistoi obolochki zheludka pri diffusnom i kishechnom rake.

The study was made of 29 intestinal type gastric carcinomas, 37 diffuse type gastric carcinomas and stomach mucosa (SM). Both carcinomas slightly differed by frequency of the fundal glands atrophy. Intestinal type was characterized by a higher frequency of antral glands atrophy, intestinal metaplasia, particularly of colon type. Intestinal cell differentiation was about the same in both types. Hyperplasia of lining and endocrine cells in the fundal part of the mucosa was more frequent and neuroendocrine differentiation was more pronounced in diffuse stomach carcinoma. It is suggested that environmental impacts including helicobacter pylori result in proliferation of the epithelium, intestinal metaplasia, dysplasia and carcinoma of the intestinal type. Diffuse carcinoma is associated with proliferation of glandular epithelium (parietal, endocrine, cervical) due to genetic factors, hypergastrinemia caused by fundal gland atrophy, alkalization of the mucosa due to Helicobacter pylori infection.

[Methods to increase the accuracy of endoscopic retrograde pancreatic cholangiography in mechanic jaundice]. / Metody povysheniia éffektivnosti éndoskopicheskoi retrogradnoí pankreatokholangiografii pri mekhanicheskoi zheltukhe.

The results of endoscopic retrograde pancreatocholangiography in 2344 patients with non-tumor extrahepatic scholestasis are analysed. In 90.7%. It was possible to get the information on the disease cause. The diagnosis was based on the results of endoscopic examination, or endoscopic and X-ray examinations. In 84.8% cases the diagnosis was correct, in 5.9% there were diagnostical mistakes. Lack of the proper X-ray information was the major cause of diagnostic problems. The use of endoscopic papillosphincterotomy, instrumental examination of bile ducts, and selective cholegraphy may improve the diagnostic accuracy. The use of these methods is especially indicated in case of serious jaundice, and in acute cholecystitis and pancreatitis. The use of these methods do not increase the rate of complications.

[The clinico-morphological characteristics and treatment of minimal-change glomerulonephritis and focal-segmental glomerulosclerosis-hyalinosis]. / Kliniko-morfologicheskaia kharakteristika i lechenie glomerulonefrita s minimal'nymi izmeneniiami, fokal'no-segmentarnogo glomeruloskleroza-gialinoza.

Clinical and morphological features were analysed of the morbid condition in 46 patients with glomerulonephritis presenting with minimal alterations (GNMA) and 12 those with focal-and-segmental glomerulosclerosis-hyalinosis (FSGH), of whom there were twenty nine males and twenty nine females ranging between 15 to 54 years. In all cases morphologic diagnosis was established on the basis of vital histologic investigation of renal tissue. Immediate results were assessed of glucocorticoid and cytostatic therapy instituted at different stages of the condition. High effectiveness was documented of glucocorticosteroids in GNMA patients along with the ability of cyclophosphamide to significantly decrease the frequency of exacerbations and make such patients free from steroid dependency. GSGH patients derived no benefit from glucocorticoids while cyclophosphamide was associated with complete GH patients azathioprine therapy had no positive effect on the course of the illness.

[The clinico-morphological characteristics of glomerulonephritis in infectious endocarditis]. / Kliniko-morfologicheskaia kharakteristika glomerulonefrita pri infektsionnom éndokardite.

Clinicomorphological characteristics of glomerulonephritis in infectious endocarditis (IEGN) were studied in 62 patients (with samples of autopsy material being used in 52 instances). IEGN presents with dissaminated and focal proliferative alterations involving extracapillary and/or tubulointerstitial components, and is characterized by a broad variability of indices for proteinuria, hematuria and cylindruria. In diffuse prolipherative glomerulonephritis the degree of proteinuria and cylindruria appear to be significantly higher than in focal segmental proliferative glomerulonephritis, as is the incidence rate of development of renal insufficiency and its gravity.

[A comparison of the differentiation of tumor cells and of the epithelium of the gastric mucosa in cancer]. / Sopostavlenie differentsirovki opukholevykh kletok i épiteliia slizistoi obolochki zheludka pri rake ego.

The correlation between differentiation of tumor cells in different directions (toward the foveolate epithelium or glandular epithelium in stomach, or small and large intestine epithelium, or endocrine cells) and the state of gastric mucosa (differentiation of its cells in direction of foveolate epithelium or glandular epithelium (hypoplasia of corresponding epithelium), or appearance of focals of metaplasia in small or large intestines, or pronounced hyperplasia of endocrine cells) was revealed in most cases of gastric cancer. The other of the disease did not reveal such correlation.

[The prognosis of the nature of the course and outcome of infectious endocarditis]. / Prognozirovanie kharaktera techeniia i iskhoda infektsionnogo éndokardita.

Prognostic significance of various clinical and laboratory indices for predicting the course and outcome of infectious endocarditis (IE) has been analyzed for 139 IE patients aged 15-68 (77 males and 62 females). The unfavourable prognosis was associated with uncontrollable sepsis, persistence of circulating immune complexes and developing glomerulonephritis. The latter had also prognostic signs unfavourable for IE: moderate or severe proteinuria and/or cylindruria, reduced renal function, diffuse proliferation, pronounced extracapillary and/or tubulointerstitial components.

[The characteristics of cylindruria in patients with chronic glomerulonephritis]. / Osobennosti tsilindrurii u bol'nykh khronicheskim glomerulonefritom.

Qualitative and quantitative indices of cylindruria were studied in 325 patients aged from 15 to 64 with various morphological forms of chronic glomerulonephritis (CGN). In 237 of them function of kidneys was unchanged while remaining 88 patients revealed various degrees of chronic renal failure (CRF). Parameters of cylindruria in patients with CGN varied widely, significant correlation having been established between presence of erythrocytic cylinders in urinary residue and degree of haematuria. Large granular cylinders were observed in patients with severe and moderate CRF as distinct from patients with normal renal function and initial stage of renal insufficiency.

[Argyrophilic proteins in the nucleolar organizer in the differential diagnosis of cervical dysplasias and cancer]. / Izuchenie argirofil'nykh belkov iadryshkovogo organizatora pri differentsial'noi diagnostike displazii i raka sheiki matki.

Prospects of using the nucleolar organizer region (NOR) identification by silver nitrate for the diagnosis of dysplasias and cervical cancer were studied. Four groups of patients (22 cases) have been examined: group 1 (7 cases)--unchanged endocervical epithelium, group 2 (6 cases)--dysplasia of cervical epithelium of degree II-III, group 3 (3 cases)--carcinoma in situ, group 4 (6 cases)--invasive squamous cell nonkeratinizing carcinoma. The investigation showed that there are reliable differences in the quantity of silver granules per nucleus and also of NOR index between normal ectocervical epithelium and dysplasia, normal ectocervical epithelium and cancer, dysplasia and cervical cancer. The data obtained suggest that NOR argyrophilia may be a diagnostic marker of the tumor malignancy degree.